Aliya Qayyum MD, Presenter: Spouse, Employee, Koninklijke Philips Electronics NV (Stentor)

Melissa Dymond DO, Abstract Co-Author: Nothing to Disclose

Antonio C. Westphalen MD, Abstract Co-Author: Nothing to Disclose

Fergus V. Coakley MD, Abstract Co-Author: Nothing to Disclose

Ying Lu PhD, Abstract Co-Author: Nothing to Disclose

Dan Vigneron PhD, Abstract Co-Author: Nothing to Disclose

To determine homogeneity and biopsy correlation of apparent diffusion coefficient (ADC) at MR imaging of patients with HIV/HCV related hepatitis.

Committee on Human Research approval and patient consent were obtained, and the study was compliant with the Health Insurance Portability and Accountability Act. Sixty patients (54 women, 5 men) with a mean age of 49 years (range, 33-60) with HIV/HCV hepatitis underwent single-shot fast spin echo diffusion tensor MR imaging of the liver. Twenty of the patients underwent contemporaneous liver biopsy. The mean ADC was calculated from 3 regions of interest measuring 3.2cc (2 in the right and 1 in the left lobe) placed at the mid-level of the liver. The Pearson’s correlation coefficient between ADC measurements was calculated to determine homogeneity of liver involvement. A mixed random effects model was used to assess the relationship between mean ADC and histopathology for the 20 subjects with liver biopsy.

Mean ADCs (95% confidence interval) in the right posterior segment, right anterior segment and left lateral segment of the liver were 1.53 (1.46-1.60), 1.73 (1.66-1.81) and 1.97 (1.90-2.05), respectively. ADC measurements demonstrated a correlation coefficient of 0.8 between right posterior and anterior segments, 0.6 between right posterior segment and left lobe, and 0.4 between right anterior segment and left lobe. For the 20 subjects with liver biopsy 15 subjects had grade 0 and 5 subjects had grade 1 steatosis. The mean ADC (95% confidence interval) for patients with grade 0 and 1 steatosis was 1.75 (1.36-2.35) and 1.39 (0.84-1.55), respectively. A negative correlation was observed between ADC and steatosis grade (p < 0.01).

ADC varies within the liver of patients with hepatitis due to co-infection by human immunodeficiency and hepatitis C viruses, but measurements from the right lobe may be preferable because they are highly correlated. Grade 1 steatosis in these patients is sufficient to produce a significant reduction in ADC.

Liver ADC varies in patients with HIV/HCV related hepatitis, but right lobe measurements are highly correlated and a significant reduction in ADC occurs with grade 1 steatosis.

Qayyum, A, Dymond, M, Westphalen, A, Coakley, F, Lu, Y, Vigneron, D, MR Imaging of HIV/HCV Hepatitis: Homogeneity and Histopathological Correlates of Apparent Diffusion Coefficient.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010085.html